Tiaoshen Jieyu acupuncture combined with sertraline hydrochloride tablet for post-stoke depression: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between Tiaoshen Jieyu acupuncture (acupuncture for regulating mind and relieving depression) combined with sertraline hydrochloride tablet and simple sertraline hydrochloride tablet for post-stroke depression (PSD).@*METHODS@#A total of 76 patients with PSD were randomized into an observation group (38 cases, 6 cases dropped off) and a control group (38 cases, 4 cases dropped off). Both groups were treated with conventional treatment i.e. controlling blood pressure and anti-inflammation. Sertraline hydrochloride tablet was given orally in the control group, 20 mg a time, once a day. On the basis of the treatment in the control group, Tiaoshen Jieyu acupuncture was applied at Baihui (GV 20), Yintang (GV 24+), Neiguan (PC 6), Taichong (LR 3), etc. in the observation group, Baihui (GV 20) and Yintang (GV 24+) were connected to electroacupuncture, with disperse-dense wave, 2 Hz/100 Hz in frequency, 30 min a time, once a day, 6 times a week. Treatment of 8 weeks was required in both groups. Before and after treatment, the scores of Hamilton depression scale (HAMD), National Institutes of Health stroke scale (NIHSS), Barthel index (BI) and Pittsburgh sleep quality index (PSQI) were observed respectively, the therapeutic efficacy and rate of adverse reactions were evaluated in the two groups.@*RESULTS@#After treatment, the scores of HAMD, NIHSS and PSQI were lower while BI scores were higher than those before treatment in both groups (P<0.05); the scores of HAMD, NIHSS and PSQI in the observation group were lower while BI score was higher than those in the control group (P<0.05). The total effective rate was 93.8% (30/32) in the observation group, which was higher than 70.6% (24/34) in the control group (P<0.05). The rate of adverse reactions was 9.4% (3/32) in the observation group, which was lower than 32.4% (11/34) in the control group (P<0.05).@*CONCLUSION@#Tiaoshen Jieyu acupuncture combined with sertraline hydrochloride tablet can improve the depression degree, neurological function, activity of daily living and sleep quality in patients with post-stroke depression, the clinical efficacy is superior to simple sertraline hydrochloride, and can alleviate the adverse reactions caused by medication.

The Effect of Neuromodulatory Drugs on the Intensity of Chronic Pelvic Pain in Women: A Systematic Review / Efeito de neuromoduladores na intensidade da dor pélvica crônica em mulheres: Revisão sistemática

Abstract Objective: To evaluate the effect of neuromodulatory drugs on the intensity of chronic pelvic pain (CPP) in women. Data sources: Searches were carried out in the PubMed, Cochrane Central, Embase, Lilacs, OpenGrey, and Clinical Trials databases. Selection of studies: The searches were carried out by two of the authors, not delimiting publication date or original language. The following descriptors were used: chronic pelvic pain in women OR endometriosis, associated with MESH/ENTREE/DeCS: gabapentinoids, gabapentin, amitriptyline, antidepressant, pregabalin, anticonvulsant, sertraline, duloxetine, nortriptyline, citalopram, imipramine, venlafaxine, neuromodulation drugs, acyclic pelvic pain, serotonin, noradrenaline reuptake inhibitors, and tricyclic antidepressants, with the Boolean operator OR. Case reports and systematic reviews were excluded. Data collection: The following data were extracted: author, year of publication, setting, type of study, sample size, intervention details, follow-up time, and results. Data synthesis: A total of 218 articles were found, with 79 being excluded because they were repeated, leaving 139 articles for analysis: 90 were excluded in the analysis of the titles, 37 after reading the abstract, and 4 after reading the articles in full, and 1 could not be found, therefore, leaving 7 articles that were included in the review. Conclusion: Most of the studies analyzed have shown pain improvement with the help of neuromodulators for chronic pain. However, no improvement was found in the study with the highest statistical power. There is still not enough evidence that neuromodulatory drugs reduce the intensity of pain in women with CPP.

Resumo Objetivo: Avaliar o efeito de drogas neuromoduladoras na intensidade da dor pélvica crônica em mulheres. Fontes de dados: As buscas foram realizadas nas bases de dados PubMed, Cochrane Central, Embase, Lilacs, OpenGrey e Clinical Trials. Seleção dos estudos: As buscas foram realizadas por dois dos autores, não delimitando data de publicação ou idioma de publicação. Foram usados os seguintes descritores: chronic pelvic pain in women OR endometriosis, associated with MESH/ENTREE/DeCS: gabapentinoids, gabapentin, amitriptyline, antidepressant, pregabalin, anticonvulsant, sertraline, duloxetine, nortriptyline, citalopram, imipramine, venlafaxine, neuromodulation drugs, acyclic pelvic pain, serotonin, noradrenaline reuptake inhibitors e tricyclic antidepressants, com o operador booleano OR. Relatos de caso e revisões sistemáticas foram excluídos. Coleta de dados: Foram extraídos os seguintes dados: autor, ano de publicação, local de origem, tipo de estudo, tamanho da amostra, detalhes da intervenção, tempo de seguimento e resultados. Síntese dos dados: Foram encontrados 218 artigos, sendo 79 deles excluídos por serem repetidos, restando 139 artigos para análise, dos quais 90 foram excluídos na análise dos títulos, 37 após a leitura do resumo e 4 após a leitura dos artigos na íntegra, e 1 não foi encontrado, restando, então, 7 artigos que foram incluídos na revisão. Conclusão: A maioria dos estudos analisados mostrou melhora da dor crônica com auxílio de neuromoduladores. No entanto, nenhuma melhora foi encontrada no artigo com maior poder estatístico. Ainda não há evidências suficientes de que drogas neuromoduladoras reduzam a intensidade da dor pélvica crônica em mulheres.

Clinical controlled study of high-frequency repeated transcranial magnetic stimulation combined with sertraline in the treatment of depression in children and adolescents / 四川精神卫生

ObjectiveTo evaluate the efficacy and safety of high frequency repetitive transcranial magnetic stimulation （rTMS） combined with sertraline in the treatment of depression in children and adolescents. MethodsFrom November 2019 to May 2020， a sample of 107 children and adolescents who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10 ） for depressive episode were selected from the Third People's Hospital of Tianshui. According to the method of random number table， individuals were classified into study group（n=53） and control group（n=54）. All subjects received sertraline treatment， based on this， study group received high-frequency rTMS （10 Hz）. Treatment in both groups lasted for 4 weeks. Efficacy was assessed using Hamilton Depression Scale-24 item （HAMD-24） at the baseline， and the end of the 1st， 2nd， 3rd and 4th weeks of treatment， and adverse reactions were evaluated via Treatment Emergent Symptom Scale （TESS） at the 1st， 2nd， 3rd and 4th weekend of treatment. ResultsThere were 50 participants in both the study group and control group. The HAMD-24 score of study group were lower than those of control group at the end of 1st， 2nd， 3rd and 4th weeks of treatment （t=2.556~3.434， P<0.05）. The overall efficacy rate at the 4th week of treatment was 90.00% in study group， which was significantly higher than 78.00% in control group （χ2=2.680， P<0.05）. The adverse reaction rate yielded no statistical difference between study group and control group （30.00% vs. 26.00%， χ2=0.200， P>0.05）. ConclusionCompared with sertraline treatment alone， its combination with high-frequency rTMS achieves better outcomes in the treatment of depression in children and adolescents， without compromising safety.

Development and optimization of cosolvent-based blended Sertraline orodispersible films - A step to personalized medicine

Abstract Personalized medicine is gaining importance in pharmacotherapeutics as it allows tailoring the drug treatment to achieve the best patient response. Orodispersible film (ODF) is easy to formulate in hospitals, produces dose flexibility to suit an individual needs, particularly for patients suffer from swallowing issues or prohibited to take fluids. Sertraline Hydrochloride (SRT) was solubilized in several cosolvents, then different SRT ODFs based on five hydrophilic polymers namely; polyvinyl alcohol (PVA), hydroxylethyl cellulose (HEC), hydroxypropyl methylcellulose E5 LV (HPMC E5 LV), sodium alginate (NaAlg) and gelatin at two concentrations (2% and 4%) were developed and characterized. The outcomes were exposed to response surface analysis to obtain the desirability results to obtain the optimized formulation. Blended ODFs were developed from 4% PVA and 2% HEC in different blends and then potassium chloride (KCl) as a pore-forming agent was added to the best formulation to investigate its dissolution enhancement effect. F14 containing 4% PVA: 2% HEC 2:1 with 5% KCl showed best physicochemical properties of suitable pH (5.6), disintegration time (6 sec), good folding endurance which released 91 % SRT after 15 min. SRT ODF is an encouraging delivery system in the course of personalized medicine for the management of depression.

Determination of fluoxetine ，norfluoxetine and sertraline concentration in human placental perfusate and their placental permeability by UFLC-MS/MS / 中国药房

OBJECTIVE To establish t he method for determining the concentrations of fluoxetine ，norfluoxetine and sertraline in human placental perfusate method and their placental permeability. METHODS Using glyburide as internal standard ，the samples were pretreated by protein precipitation method and detected by ultra-fast liquid chromatograph-mass spectrometer/mass spectrometer （UFLC-MS/MS）. The determination was performed on Synergi TM Hydro-RP 80A LC column with mobile phase consisted of water （containing 0.1％ formic acid ）-acetonitrile（containing 0.1％ formic acid ）at the flow rate of 0.70 mL/min，with a gradient elution. The column temperature was set at 40 ℃，and sample size was 5 μL. Detection was performed with electrospray ionization source in multipl e reaction monitoring mode . The ion pairs for quantitative analysis we re m/z 309.9→148.1（fluoxetine），m/z 296.0→134.4 （-167）， （norfluoxetine），m/z 306.1→159.0 （sertraline），m/z 493.9→ No.2018FE001（-207），（internal standard ）. The perfusion model of singal placenta under bidrectional cardiopulmonary bypass was established. Fluoxetine （160 ng/mL），norfluoxetine（160 ng/mL）， sertraline（100 ng/mL）and antipyrine （positive control ，ng/mL）were added into the maternal perfusate. The concen- 65324888 trations of fluoxe tine， norfluoxetine and sertrali ne were measured by above UFLC-MS/MS at 0，10，20，30，45，60，90，120，150 and 180 min of circulation ，and the placental permeability was calculated. RESULTS The linear range of fluoxetine ，norfluoxetine and sertraline were 5.00-500 ng/mL（all r＞ 0.990），and the lower limits of quantification were all 5.00 ng/mL. The RSDs of intra-day and inter-day were all less than 14.0％， and relative error ranged －9.6％ to 14.7％. The relative error of stability test was －4.0％ to 11.0％；the residual effect ，extraction method and matrix effect did not affect the quantitative analysis of the substance to be tested. Totally 31 perfusion model of human placenta under cardiopulmonary bypass were successfully established ，including 15 fluoxetine and norfluoxetine perfusion ，10 sertraline perfusion and 6 antipyrine perfusion. After 3 hours of perfusion ，the average placental permeability of fluoxetine ， norfluoxetine and sertraline were （8.74 ± 1.67）％ ，（10.70 ± 4.81）％ ，（5.90 ± 1.25）％ ，respectively. CONCLUSIONS The established UPLC-MS/MS is simple ，sensitive and accurate. It can be used for determination of fluoxetine ，norfluoxetine and sertraline in human placental perfusate. Fluoxetine ，norfluoxetine and sertraline can pass through the placenta ，but sertraline has a lower placental permeability.

The effect of transcranial magnetic stimulation combined with sertraline on post-stroke depression / 中国医师进修杂志

Objective:To explore the effect of transcranial magnetic stimulation (TMS) combined with sertraline on post-stroke depression (PSD).Methods:A total of 94 PSD patients admitted Zibo Fifth People's Hospital from June 2018 to June 2020 were selected as the research objects, and they were divided into observation group (47 cases) and control group (47 cases) according the treatment methods. The control group was treated with TMS, and the observation group was treated with TMS combined with sertraline. After treatment of 12 weeks, the clinical effects, neurological function scores, serological indicators, cognitive function and incidence of adverse reactions of the two groups were evaluated and compared.Results:The total effective rate in the observation group was higher than that in the control group: 91.49% (43/47) vs. 72.34% (34/47), the difference was statistically significant (χ 2 = 5.82, P<0.05). After treatment, the scores of National Institutes of Health Stroke Scale(NIHSS) and Hamilton′s Depression Scale -17 (HAMD-17) in the observation group were lower than those in the control group: (5.45 ± 1.97) scores vs. (7.89 ± 2.18) scores, (8.18 ± 2.34) scores vs. (10.27 ± 2.97) scores; the scores of Glasgow Coma Scale (GCS) in the observation group were higher than those in the control group: (26.23 ± 3.18) scores vs. (23.42 ± 2.90) scores, the differences were statistically significant ( P<0.01). After treatment, the level of C-reactive protein (CRP) in the observation group was lower than that in the control group: (8.28 ± 2.78) mg/L vs. (10.76 ± 2.99) mg/L; the level of 5-hydroxytryptamine (5-HT) in the observation group was higher than that in the control group: (196.12 ± 20.71) μmol/L vs. (177.98 ± 19.94) μmol/L, the differences were statistically significant ( P<0.01). After treatment, the scores of cognitive function screening scale (CASI) in the observation group, including attention, orientation, memory, fluency of thinking and language expression were higher than those in the control group ( P<0.05). The incidence of adverse reactions in the two groups had no significant difference ( P>0.05). Conclusions:TMS combined with sertraline has a good effect on PSD, which can improve neurological function, serological indicators and cognitive function, with low adverse reactions.

Uma abordagem atual da utilização de antidepressivos no manejo da depressão pós-parto / A current approach to the use of antidepressants in the management of postpartum depression / Enfoque actual de la utilización de antidepresivos en el manejo de la depresión postparto

OBJETIVO: caracterizar a utilização de antidepressivos no manejo da depressão pós-parto. MÉTODO: empregou-se uma revisão integrativa de literatura, das bases de dados PubMed e Biblioteca Virtual em Saúde, com aplicação de descritores, visando responder a pergunta norteadora do trabalho, entre os dias 25 de fevereiro e 10 de março de 2019. Com base nos critérios de inclusão e exclusão, foram selecionados 23 artigos que, posteriormente, foram submetidos à categorização. RESULTADOS: a sertralina deve ser a droga de escolha para o tratamento farmacológico da depressão puerperal. Constatou-se também, que a utilização profilática de antidepressivos em mulheres susceptíveis é contestável e pouco se sabe sobre os possíveis efeitos colaterais. Ademais, foi encontrado que não há consenso sobre a superioridade da terapia farmacológica em detrimento às psicoterapias. CONCLUSÃO: há evidencias que fundamentam o uso de sertralina, paroxetina, duloxetina, nortriptilina e imipramina para tratar mulheres com depressão pós-parto, sendo a amamentação sempre recomendada. Ressalta-se que emerge a necessidade de estudos com amostras representativas para validar ou restringir o uso de psicofármacos na profilaxia da depressão puerperal.

OBJECTIVE: this study aimed to characterize the use of antidepressants in the management of postpartum depression. METHOD: an integrative literature review of the PubMed and Virtual Health Library databases was used, with the application of descriptors, aiming to answer the guiding question of the work, between February 25th and March 10th, 2019. Based on the inclusion and exclusion criteria, 23 articles were selected that were later submitted to categorization. RESULTS: sertraline should be the drug of choice for the pharmacological treatment of puerperal depression. It was also found that the prophylactic use of antidepressants in susceptible women is controversial and little is known about the possible side effects. In addition, it was found that there is no consensus on the superiority of pharmacological therapy to the detriment of psychotherapies. CONCLUSION: there is evidence supporting the use of sertraline, paroxetine, duloxetine, nortriptyline and imipramine to treat women with postpartum depression, and breastfeeding is always recommended. It is worth noting that the need for studies with representative samples to validate or restrict the use of psychotropic drugs in the prophylaxis of puerperal depression emerges.

OBJETIVO: el presente estudio tuvo como objetivo caracterizar la utilización de antidepresivos en el manejo de la depresión posparto. MÉTODO: revisión integradora de literatura, de las bases de datos PubMed y Biblioteca Virtual de Salud, con aplicación de descriptores, para responder a la pregunta orientadora del trabajo, entre el 25 de febrero y el 10 de marzo de 2019. Con base en los criterios de inclusión y exclusión, se seleccionaron 23 artículos que posteriormente se sometieron a categorización. RESULTADOS: la sertralina debe ser la droga elegida para el tratamiento farmacológico de la depresión puerperal. Además, se constató que la utilización profiláctica de antidepresivos en mujeres susceptibles es discutible y poco se sabe sobre los posibles efectos colaterales. Asimismo, se encontró que no hay consenso sobre la superioridad de la terapia farmacológica en detrimento de las psicoterapias. CONCLUSIÓN: hay evidencias que fundamentan el uso de sertralina, paroxetina, duloxetina, nortriptilina e imipramina para tratar a mujeres con depresión posparto, siendo la lactancia siempre recomendada. Se destaca que surge la necesidad de realizar estudios con muestras representativas para validar o restringir el uso de psicofármacos en la profilaxis de la depresión puerperal.

Efficacy of sertraline combined with low-dose olanzapine in patients with depression and anxiety comorbidity / 四川精神卫生

ObjectiveTo observe the efficacy and safety of sertraline combined with low-dose olanzapine in the treatment of depression and anxiety comorbidity and its effect on sleep quality， so as to provide references for the related clinical treatment. MethodsA total of 121 patients who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for depressive episode and generalized anxiety disorder in The Third People's Hospital of Tianshui and the Sanatorium for Mental Illness of Veterans in Tianshui from October 2019 to August 2020 were enrolled， and they were divided into two groups according to the random number table method. Study group （n=61） received sertraline combined with low-dose olanzapine， while control group （n=60） received sertraline only. Then the disease severity degree， sleep quality and adverse reactions were assessed using Hamilton Depression Scale - 17 item （HAMD-17）， Hamilton Anxiety Scale （HAMA）， Pittsburgh Sleep Quality Index （PSQI） and Treatment Emergent Symptom Scale （TESS） at the baseline， 1st， 2nd， 4th， 6th and 8th weekend， respectively. ResultsPost-treatment HAMD-17， HAMA and PSQI scores in both groups were lower than those before treatment （P<0.05）. At each time point after treatment， HAMD-17， HAMA and PSQI scores of study group were lower than those of control group， with statistical significance （P<0.05）. ConclusionSertraline alone and its combination with low-dose olanzapine are both effective in the treatment of depression and anxiety comorbidity， while the combination therapy achieves better efficacy and higher safety in alleviating anxiety and insomnia symptoms.

Interview and treatment of a case with body dysmorphic disorder / 四川精神卫生

This paper reported a case of patient with body dysmorphic disorder in order to improve the clinical interview skills， diagnosis and treatment of clinicians in psychiatric department. The client was a 17-year-old unmarried male， came for psychological consultation because he was not satisfied with his appearance and had low self-esteem. After the changing of learning environment， the client showed excessive attention to his appearance along with low mood. The client was diagnosed with body dysmorphic disorder， and a biological-psychosocial comprehensive intervention was recommended. Sertraline combined with quetiapine was given as biotherapy to improve his mood and cognition. The psychotherapy included mindfulness-based stress reduction and cognitive behavioral therapy. These therapies helped the client learn to relax and correct cognitive biases. In terms of social resources， family members were encouraged to pay more attention to the client’s advantages， and schoolwork management on campus was strengthen. These methods promoted the development of client’s self-confidence.

Sertraline combined with low-dose aripiprazole in the treatment of obsessive-compulsive disorder in children and adolescents： a randomized controlled study / 四川精神卫生

ObjectiveTo investigate the efficacy and safety of sertraline combined with low-dose aripiprazole in the treatment of obsessive-compulsive disorder in children and adolescents. MethodsA total of 62 cases pediatric patients aged 9~16 years who attended the outpatient clinic of a psychiatric hospital in Xiamen from June 2018 to May 2020 and met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for obsessive-compulsive disorder were enrolled in the study. The selected children were randomly classified into two groups for different treatments. Control group （n=30） received sertraline monotherapy， and study group （n=32） received sertraline combined with low-dose aripiprazole treatment. At the baseline and the end of the 2nd， 4th， 8th and 12th weeks of treatment， children were assessed using Children's Yale-Brown Obsessive Compulsive Scale （CY-BOCS） and Treatment Emergent Symptoms Scale （TESS）. Thereafter， the clinical efficacy and adverse reactions were compared between two groups. ResultsThe compulsive behavior dimensional score of CY-BOCS of study group was lower than that of control group at end of the 2nd and 4th weeks of treatment （t=-2.083， -2.176， P<0.05）. At the end of the 2nd week of treatment， the effective rate was 40.63% in study group， which was significantly higher than 3.33% in control group （χ2=12.317， P<0.01）. By the end of the 12th weeks of treatment， the incidence rate of side effects yielded no statistical difference between two groups （χ2=1.608， P=0.205）. ConclusionCompared with sertraline monotherapy， its combination with low-dose aripiprazole treatment can effectively accelerate the improvement of clinical symptoms in childrenand adolescents with obsessive-compulsive disorder， while the combination therapy and sertraline monotherapy have equivalent safety.

Effect of auricular acupuncture on reduction of sertraline hydrochloride in patients with depression: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of auricular acupuncture on reduction rate of sertraline hydrochloride, and to explore the long-term efficacy of auricular acupuncture in patients with depression.@*METHODS@#Seventy-two patients with depression were randomly divided into an observation group (36 cases, 1 case dropped off) and a control group (36 cases, 2 cases dropped off). The patients in the control group were treated with conventional dosage reduction method, that is, the dosage of sertraline hydrochloride was reduced by 25% every week until the dosage was stopped completely on the premise of no aggravation of depressive symptoms. Based on the conventional dosage reduction method used in the control group, the patients in the observation group were treated with auricular acupuncture at Xin (CO@*RESULTS@#The dosage of sertraline hydrochloride in the observation group was less than that in the control group after 2, 3, 4 weeks of dosage reduction and during follow-up (@*CONCLUSION@#Auricular acupuncture could effectively reduce the dosage of sertraline hydrochloride, improve the dosage reduction rate, reduce the incidence of withdrawal syndrome and reduce the risk of long-term recurrence in patients with depression.

A comparative prospective open label randomized controlled 8 week study in patients of depression treated with vilazodone and sertraline

Background: Depression is a mood disorder treated with various antidepressant such as SSRIs due to lesser toxicity and improved safety profile.Methods: This was an eight week randomised active controlled parallel group study. 54 patients were allocated in two group. Group A received vilazodone while group B received sertraline. Assessment done at baseline, 2, 4 and 8 weeks on the basis of clinical efficacy, sexual dysfunction, side effects and weight gain using Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Arizona Sexual Experience Scale (ASEX) and UKU Side Effect Rating Scale.Results: HAM-D score of group A was 18.78±1.78 and 7.67±1.66 while in group B was 19.04±2.12 and 8.15±1.77 at baseline and 8 weeks respectively. HAM-A score of group A was 15.44±1.50 and 6.63±1.39 while in group B was 15.26±1.83 and 7.07±1.14 at baseline and 8 weeks. ASEX total score of group A was 15.63±1.28 and 14.63±1.33 while group B was 15.52±1.37 and 16.41±1.12 at baseline and 8 weeks. ASEX desire score of group A was 9.63±0.93 and 8.67±0.88 while of group B was 9.59±0.93 and 10.07±0.92 at baseline and 8 weeks. UKU side effect rating at 2 and 8 weeks of group A was 0.22±0.42, 1.04±0.76 while in group B was 0.37±0.49, 1.89±0.85.Conclusions: Vilazodone and Sertraline are equally efficacious in treatment of depression and associated anxiety. When side effect profile were compared Vilazodone is found superior to Sertraline

Synergistic effect of sertraline and disulfiram against multidrug resistant bacteria as a new alternative to drug repositioning

The repositioning of approved drugs is atopic of interest for the academy and the pharmaceutical industry. The synergistic combination of these drugs can be successful in the treatment of infections caused by resistant bacteria. This study aimed to assess the in vitro synergistic antibacterial activity of sertraline and disulfiram and their interaction with ciprofloxacin and sulfamethoxazole/trimethoprim. We determined the minimum inhibitory concentration, the minimum bactericidal concentration and the fractional inhibitory concentration index. Eighteen bacterial strains were used, being nine American Type Culture Collection reference strains and nine multidrug resistant clinical isolates. Synergy was detected between sertraline and disulfiram against a strain of Staphylococcus aureusATCC 25923 and a clinical isolate of S. aureus. When associated to sulfamethoxazole/trimethoprim and ciprofloxacin, sertraline and disulfiram showed eight synergistic events, which occurred against three different standard strains and two multidrug resistant clinical isolates. When the minimum bactericidal concentration was determined, the bactericidal activity of sertraline was enhanced with disulfiram. Our results suggest that these drugs, widely used to treat depression and chronic alcoholism, have antibacterial potential individually, in association, and combined with antimicrobials, what makes their repositioning a promising therapeutic alternative for the effective treatment of infections caused by multidrug resistant bacteria.

Hepatotoxicidad grave inducida por sertralina / Sertraline-induced severe hepatotoxicity

We report the case of a 19-year-old patient, with a history of traumatic liver damage, but with a normal liver profile at her first discharge; 1 month after the event, with post-traumatic stress disorder, treatment with 25 mg of sertraline was started every day; one month later, she develops severe hepatotoxicity without a specific etiology. According to the Naranjo algorithm, it is attributed as a probable case of sertraline hepatotoxicity. Management is carried out with support measures and suspension of the medication, and the patient recovers until she is asymptomatic, currently has normal liver tests

Reportamos el caso de una paciente de 19 años, con antecedentes de daño hepático traumático, pero con un perfil hepático normal en su primer alta; después de 1 mes del evento, con trastorno de estrés postraumático se inició tratamiento con 25 mg diarios de sertralina; un mes después, desarrolla una hepatotoxicidad severa sin etiología determinada. De acuerdo con el algoritmo de Naranjo, se atribuye como caso probable de hepatotoxicidad por sertralina. El manejo se realiza con medidas de apoyo y suspensión del medicamento, y la paciente se recupera hasta que se encuentra asintomática, actualmente tiene pruebas hepáticas normales

Single-run reversed-phase HPLC method for determining sertraline content, enantiomeric purity, and related substances in drug substance and finished product / 药物分析学报

A direct enantio-, diastereo-, and chemo-selective high-performance liquid chromatographic method was developed for determining the content, enantiomeric purity, and related substances of the chiral antidepressant drug sertraline HCl in a single chromatographic run. The separation was achieved on a chiral stationary phase based on amylose tris(3-chloro-5-methylphenylcarbamate) under reversed-phase conditions. The method was optimized by evaluating the influence of the temperature and mobile phase composition on the retention and selectivity. The application of the single-run approach allowed to baseline resolve all investigated species in less than 15 min, without using buffers or tandem-coupled columns. The chromatographic method was validated according to the guidelines of the Official Medi-cines Control Laboratory and applied to control the content of sertraline HCl and related chiral sub-stances in a generic antidepressant formulation.

Effects of SSRI antidepressant sertraline on ocular surface function in patients with postpartum depression / 中国临床药理学与治疗学

AIM: To investigate the effect of SSRI antidepressant sertraline on ocular surface function in patients with postpartum depression.METHODS: This was a prospective case-control study. Forty-three patients diagnosed as postpartum depression receiving sertraline for the first time were investigated with the HAMD, OSDI, TBUT, SIT, FL, tear osmolarity and IL-6, MMP-9 before medication and 2 months after medication. The changes of dry eye indexes before and after medication were compared.RESULTS:After 2 months of medication, HAMD score was significantly decreased, with statistically significant differences (P0.05). After 2 months of medication, OSDI score increased, TBUT time shortened significantly, tear secretion decreased, FL score increased, tear osmolarity increased. The differences were statistically significant (P0.05), which indicated that tear osmolarity, tear inflammatory factor and tear metalloproteinase expression level increased when dry eye occurred. CONCLUSION:Sertraline can effectively relieve and cure postpartum depression, but long-term administration can cause damage to ocular surface function, leading to an increase in the incidence of dry eye.

Effects of sertraline in the prevention of low blood pressure in patients undergoing hemodialysis / Efeitos da sertralina na prevenção de hipotensão arterial em pacientes submetidos à hemodiálise

Abstract Introduction: Intradialytic hypotension (IDH) is a major complication of hemodialysis, with a prevalence of about 25% during hemodialysis sessions, causing increased morbidity and mortality. Objective: To study the effects of sertraline to prevent IDH in hemodialysis patients. Methods: This was a double-blind, crossover clinical trial comparing the use of sertraline versus placebo to reduce intradialytic hypotension. Results: Sixteen patients completed the two phases of the study during a 12-week period. The IDH prevalence was 32%. A comparison between intradialytic interventions, intradialytic symptoms, and IDH episodes revealed no statistical difference in the reduction of IDH episodes (p = 0.207) between the two intervention groups. However, the risk of IDH interventions was 60% higher in the placebo group compared to the sertraline group, and the risk of IDH symptoms was 40% higher in the placebo group compared to the sertraline group. Survival analysis using Kaplan-Meier estimator supported the results of this study. Sertraline presented a number needed to treat (NNT) of 16.3 patients to prevent an episode from IDH intervention and 14.2 patients to prevent an episode from intradialytic symptoms. Conclusion: This study suggests that the use of sertraline may be beneficial to reduce the number of symptoms and ID interventions, although there was no statistically significant difference in the blood pressure levels.

Resumo Introdução: A hipotensão intradialítica (HID) é uma das principais complicações da hemodiálise, com uma prevalência de cerca de 25% durante as sessões de hemodiálise, causando aumento da morbimortalidade. Objetivo: Estudar os efeitos da sertralina na prevenção da HID em pacientes em hemodiálise. Métodos: Este foi um ensaio clínico duplo-cego, cruzado, comparando o uso de sertralina versus placebo para reduzir a hipotensão intradialítica. Resultados: Dezesseis pacientes completaram as duas fases do estudo durante um período de 12 semanas. A prevalência de HID foi de 32%. Uma comparação entre intervenções intradialíticas, sintomas intradialíticos (ID) e episódios de HID não revelou diferença estatística na redução dos episódios de HID (p = 0,207) entre os dois grupos de intervenção. No entanto, o risco de intervenções para HID foi 60% maior no grupo placebo em comparação com o grupo Sertralina, e o risco de sintomas ID foi 40% maior no grupo placebo em comparação com o grupo Sertralina. A análise de sobrevida utilizando o estimador de Kaplan-Meier corroborou os resultados deste estudo. A sertralina apresentou um número necessário para tratar (NNT) de 16,3 pacientes para prevenir um episódio de intervenção de HID e 14,2 pacientes para prevenir um episódio de sintomas intradialíticos. Conclusão: Este estudo sugere que o uso de sertralina pode ser benéfico para reduzir o número de sintomas e intervenções de HID, embora não tenha havido diferença estatisticamente significante nos níveis pressóricos.

The relationship of peripheral blood single uncoding RNA-25-3p expression level and the sertraline efficacy in patients with panic disorder / 中华行为医学与脑科学杂志

Objective@#To identify potential relationship between single uncoding RNA-25-3p (miR-25-3p) expression level and the sertraline efficacy in patients with panic disorder.@*Methods@#Sixty cases of patients with panic disorder(case group) and sixty healthy-controls(control group) were collected with demographic data and peripheral venous blood before and after treatment.All the patients were evaluated using the 14-item Hamilton Anxiety Rating Scale (HAMA) and Panic Disorder Severity Scale (PDSS) at baseline, and then received sertraline treatment for 6 weeks.After six-week treatment, each patient was evaluated again with HAMA and PDSS.RT-PCR was used to detect the level of miR-25-3p expression.@*Results@#There was no significant difference in the miR-25-3p levels between control group (1.27±0.32) and case group (1.73±1.09) before treatment(t=1.53, P=0.14), but the levels in case group were much higher than that in control group after the treatment (5.72±4.13 vs 1.73±1.09, t=-2.15, P=0.04). Besides, the changes of the miR-25-3p levels were positively related with both the changes of PDSS3 and PDSS7 items before and after the treatment (r=0.60, P=0.02 for PDSS3 and r=0.61, P=0.02 for PDSS7).@*Conclusions@#miR-25-3p is associated with the drug efficacy and the outcome of some clinical symptoms of panic disorder.These findings might provide some evidence for the individualized treatment of patients with panic disorder according to regulation of gene expression in the future.

The relationship of peripheral blood single uncoding RNA-25-3p expression level and the sertraline efficacy in patients with panic disorder / 中华行为医学与脑科学杂志

Objective To identify potential relationship between single uncoding RNA-25-3p (miR-25-3p) expression level and the sertraline efficacy in patients with panic disorder.Methods Sixty cases of patients with panic disorder(case group) and sixty healthy-controls(control group) were collected with demographic data and peripheral venous blood before and after treatment.All the patients were evaluated using the 14-item Hamilton Anxiety Rating Scale (HAMA) and Panic Disorder Severity Scale (PDSS) at baseline,and then received sertraline treatment for 6 weeks.After six-week treatment,each patient was evaluated again with HAMA and PDSS.RT-PCR was used to detect the level of miR-25-3p expression.Results There was no significant difference in the miR-25-3p levels between control group (1.27±0.32) and case group (1.73±1.09) before treatment(t=1.53,P=0.14),but the levels in case group were much higher than that in control group after the treatment (5.72±4.13 vs 1.73±1.09,t=-2.15,P=0.04).Besides,the changes of the miR-25-3p levels were positively related with both the changes of PDSS3 and PDSS7 items before and after the treatment (r=0.60,P=0.02 for PDSS3 and r=0.61,P=0.02 for PDSS7).Conclusions miR-25-3p is associated with the drug efficacy and the outcome of some clinical symptoms of panic disorder.These findings might provide some evidence for the individualized treatment of patients with panic disorder according to regulation of gene expression in the future.

Clinical observation of acupuncture combined with sertraline hydrochloride tablets on tumor-related depression / 中国针灸

OBJECTIVE@#To compare the clinical effects of acupuncture combined with sertraline hydrochloride and simple sertraline hydrochloride on tumor-related depression.@*METHODS@#Sixty patients with tumor-related depression who met the inclusion criteria were randomly assigned to an observation group and a control group, 30 patients in each group. The routine treatment in department of oncology were given in both groups, oral sertraline hydrochloride (25 mg daily for the first 5 days, then 50 mg daily) was given in the control group; on the basis of the treatment in the control group, and acupuncture was applied at Hegu (LI 4), Neiguan (PC 6), Taichong (LR 3), Shenmen (HT 7)，etc. in the observation group，twice a week .The two groups were treated continuously for 4 weeks. The Hamilton depression scale (HAMD) score and the quality of life score (QLQ-C30 questionnaire) were compared between the two groups before and after treatment.@*RESULTS@#After treatment, the HAMD scores in the two groups were significantly lower than those before treatment (both <0.05), and the HAMD scores in the observation group were lower than those in the control group (<0.05). In the observation group, the symptom scores of fatigue, pain, nausea and vomiting, dyspnea, insomnia, loss of appetite, constipation, and diarrhea were significantly lower than those before treatment (all <0.05), and the physical, cognitive, emotional function, and the overall quality of life score were significantly higher than those before treatment (all <0.05); in the control group, the symptom scores of insomnia decreased compared with that before treatment (<0.05), and the emotional function and overall quality of life score were higher than those before treatment (both <0.05); in addition to economic difficulties, roles and social functions, the other scores after treatment in the observation group were significantly improved than those in the control group (all <0.05).@*CONCLUSION@#The combination of acupuncture and sertraline hydrochloride tablets is better than simple sertraline hydrochloride in the treatment of tumor-related depression, and it can improve the accompanying symptoms and improve quality of life.